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Thomas P. Connelly, D.D.S. Headshot

Mouth Health: Good vs Bad Cosmetic Dentistry

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We know that all dentists are not created equally; we have seen the bad veneer makeovers glowing in the dark (chicklet teeth), and the dental crown smiles with black lines showing thru the gums. Did you know that a big part of these dental nightmares is determined by the ceramist that your dentist chooses to work with? Dentists can use small "boutique" style ceramists that create each tooth like a sculpture - or they can opt for a veneer from a national chain type laboratory that spits veneers out of a machine for sometimes 90 percent less cost!

In 2002 I founded Oral Design Boston, a ceramics laboratory, on Newbury street in Boston, MA with world-renowned ceramist Yasu Kawabe from Japan. From importing rare porcelain vacuumed furnaces from Germany and Hawaii, to testing microscopes and elaborate porcelain combinations -- I was involved extensively in developing the technical and laboratory portion of high end porcelain veneer fabrication. Understanding and managing every step in the process is vital to ensure superb porcelain aesthetics when dealing with high-level cosmetic dentistry. Some of the most published Cosmetic Dentists do not understand the technical aspect of veneer fabrication and proper material specifications. Critical information is frequently skipped or omitted in the dental veneering process, simply because dentists have been able to "get by" without truly understanding each and every step. This is just one of the many aspects of cosmetic dentistry that people need to investigate when choosing their cosmetic dentist -- who is their dentist's ceramist, and how involved is your dentist going to be in the laboratory process."

Truly beautiful veneers are interpreted as beautiful teeth. These veneers are stealth to everyone's eyes and subconscious. The optical properties of the porcelain are the key. When I write "optical properties" what I am saying is -- the way human eyes perceive light reflecting and passing through the veneers.

Here are facts I must elaborate and simplify before I continue:

-white is actually the absence of color

-something that is white is reflecting light back at the person looking at it

-conversely, black is absorbing all light and reflecting none

-all colors in between white and black absorb, and reflect light in different amounts, giving that object a "color."

-a ceramic toilet, a piece of Chicklet gum. a white piece of paper, and a white sock all reflect, scatter, and absorb light completely differently -- yet they are all white

So when we are creating porcelain veneers, we want to use a porcelain that reflects light, in the same manner and degree as human enamel reflects light. We also want the structure of the material (the lattice work, framing, building blocks) of the veneer to be assembled similarly to human enamel. Otherwise, even thought a material may be white, as we see above; it doesn't necessarily mean it will look like a tooth.

Dentists have choices when they decide which technician will make your porcelain veneers. Dentists can choose veneers milled by a machine from a block of engineered solid glass Lucite. Or your dentist can choose veneers made by hand, layer after layer, by a trained artists out of feldspathic porcelain. There are many laboratories, material and technicians. It is very important for you to understand this process so you can be a part of the decision making when your dentist sends your work to be fabricated.

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